Behind the Scenes at NDSC: An Interview with Ben Gold, Product Manager

Addressing the needs of NDSC customers, the market and managing NDSC’s expanding relationship with Mayo Clinic to develop ground-breaking solutions.

Ben Gold

Product Manager, NDSC

Ben has served as the product manager for NDSC’s CareSelect™ Lab and CareSelect™ Blood. Ben’s role is to quarterback the launch and management of our CareSelect Clinical Decision Support solutions. He connects-the-dots internally and focuses on addressing the needs of our customers and the market. Ben also manages NDSC’s expanding relationship with Mayo Clinic to develop ground-breaking solutions.

“My day ranges from troubleshooting a technical issue to helping to shape our messaging around product benefits for commercial payors and ACOs. At the end of the day, what I do is meaningful, satisfying, stimulating, and pretty difficult – what more could you want!”

What is your role at NDSC and what aspects do you enjoy the most?

I am a product manager for CareSelect Lab, CareSelect Blood, and as with all of our solutions there is a strong tie to our work to automate prior authorization. My favorite aspect of the role is supporting a cross-functional team and charting the future of the product. It’s satisfying to know every nook and cranny of the products: EHR specific implementation details; interactions with our code-base; key contractual details; and specifics for the sales team.

My day ranges from troubleshooting a technical issue to helping to shape our messaging around product benefits for commercial payors and ACOs. At the end of the day, what I do is meaningful, satisfying, stimulating, and pretty difficult – what more could you want!

What has been your team’s greatest accomplishment at NDSC?

There are two main areas of pride for our team. The first is the speed that we developed CareSelect Lab and made it available to the market. The second is building and expanding NDSC’s relationship with Mayo Clinic to cover additional content areas.

Our engineering team has developed a platform flexible and powerful enough to create CareSelect Lab in a matter of months. The time from content hand-off to being ready for our first install was close to 90 days. That’s speed that makes you re-think how fast healthcare I.T. can move.

Regarding our expanding relationship with Mayo Clinic, as a company, we pride ourselves on the authenticity and depth of our relationships with our clinical and EHR partners. Mayo Clinic, as an organization, is a tough group to win over. There are vendors and partners that line up around the block to work with them. It’s a well-deserved honor and testament to our work together to continue expanding our relationship.

Can you explain the importance of NDSC’s relationship with Mayo Clinic?

Our roots are in imaging, and we have an ongoing, deep relationship with the American College of Radiology (ACR). We deliberately work with leading academic medical societies and academic medical centers to transform their clinical rules into guidelines and deliver those guidelines to providers at the point-of-order. Each clinical service line is different. We knew there was a need, but there was a lack of vetted content with the breadth and depth we saw our customers were clamoring for.

Enter Mayo Clinic and Mayo Medical Labs, a US News and World Report number one hospital, the fourth largest reference lab, and a leader in integrated care delivery. Mayo Clinic authored 1,500 best practice guidelines for ordering labs ranging from daily labs to high-cost genetic and molecular tests. In a narrow sense, no other organization could bring to the table what Mayo Clinic could for the lab space.

Zooming out, Mayo Clinic has a wealth of clinical expertise and an organizational dedication to disseminating that knowledge across healthcare. We see a natural alignment between world class clinical care with academic scholarship and our highly scalable clinical content delivery platform with deep relationships with EHRs – the future is bright.

What makes the collaboration between NDSC and Mayo Clinic unique?

A business relationship can look and feel a lot of different ways. On one side of the spectrum is the quid-pro-quo approach; I do something for you and then you do something for me. On the other side of the spectrum, which is where I place Mayo Clinic and NDSC, you are working together in pursuit of a shared goal that aligns with your shared values. In a matter of months, we felt like NDSC was part of the Mayo Clinic family and like Mayo Clinic was part of the NDSC family. That’s the difference that makes our partnership unique

Can you elaborate on the process of transforming Mayo Clinic’s advisories into actionable clinical guidance for CareSelect Lab?

It’s a difficult and complicated process. I applaud any organization with the resource commitment and wherewithal to do this in-house because it is a serious undertaking. Between both organizations, we have approximately 10 full-time informaticists, equally split, devoted to curating clinical content and transforming it into the I.T. logic deployable by the CareSelect Platform.

Mayo Clinic proposes clinical rules that are thoroughly vetted by the cross-functional Clinical Practice Committee (CPC). The CPC’s membership includes pathology and other traditionally represented clinical specialties: Internal Medicine, Emergency Medicine, and so on. What’s unique about Mayo Clinic’s process is the rigor each rule goes through and the commitment to, at minimum, yearly reviews of the recommendation.

Once a rule is approved, the logic and supporting academic literature is handed over to NDSC to build, test, and package up the logic. I like to think we have the easy part of this effort, the thousands of hours of spent researching, debating, and agreeing to the clinical logic is the larger effort.

Why a lab solution?

A combination of reasons. First, our customers saw what we could do with CareSelect Imaging and were asking how we can help with lab. The real question is why does lab need a CDS solution that affects ordering clinical behavior?

20-40% of lab tests are unnecessary and wasteful. The margins on reimbursement are shrinking across healthcare and acutely in lab with downward price pressure from the 2018 CMS Lab Fee Schedule. As health systems are transitioning to value-based care arrangements with their payors, quality and reimbursement are aligning around the best care for a patient. At the same time, molecular, genetic, and specialty tests are increasing in price. We see labs feeling the pressure to do more with less and the looming threat of being outsourced. Most difficult, their hands are tied when it comes to the folks that affect their bottom lines. Looking at it from that perspective, labs are some of the hungriest clinicians for CDS and care model standardization.

What aspect of NDSC’s CareSelect Lab do you find most valuable and why?

Our genetics and molecular content, hands down. What we hear consistently from ordering clinicians, pathologists, and payors is that staying up to date with the best practices of genetic test orders is difficult. With rapid advancement and changes in genetics testing, it’s an area that benefits everyone.

How has NDSC’s partnership with Mayo Clinic expanded and evolved the CareSelect Platform?

Mayo Clinic’s content and thought leadership caused us to re-think how we look at CDS and the direction of patient care.

Mayo Clinic’s integrated practice model produces a unique perspective on patient care driven by the suspected condition. We’ve always supported pathways and arranging information as a series of decision trees, but never stepped back and holistically evaluated how a team of clinicians treat a condition.

Step one in a patient’s care odyssey starts with the PCP and the underlying condition becomes less pixelated each step of the way as the patient moves towards more specialized practitioners. This perspective of organizing clinical knowledge was an eye-opener for us.

Looking forward, how do you see CDS evolving?

The future of medicine is the return to what we want medicine to be focused on: providers and patients making shared and informed decisions about what to do next. If we can eradicate the knowledge gap for providers such that any patient – anywhere – can receive the best care in accordance with the research, then what is left for CDS to do?

Choosing Wisely was and is barking up the right tree, the concept of shared decision making is the future of medicine. We can strip away the promising science and new, fad technologies, but what are we left with? Providers that know the best choices available and a patient that can share in determining what is best for them. It’s easy to get caught up in the “what” and “how” of the new technologies and clinical innovations. It’s harder and more important to step back and remember why these advances are important and get back to the core of enabling providers to practice high quality medicine.

Outside of your professional life, what do you do for fun?

I live in Madison with my wife, Katie and two cats, Remy and Bella. Outside of work, I love to travel abroad, drink wine, read books, play squash, cook, and spend time with friends and family. Also, I’m a huge healthcare policy and industry nerd. It’s funny, and not surprising to me, that my personal blurb is ten times shorter and less interesting than my musings on healthcare.